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Now Is No Time to Abandon Hope – or Our Efforts - for Health Reform That Works for Women...

Posted by Lisa Codispoti, Senior Counsel | Posted on: January 20, 2010 at 05:29 pm

by Lisa Codispoti, Senior Counsel, 
National Women's Law Center 

There is a lot of Wednesday morning quarterbacking about the reasons for, and impact of, yesterday’s election in Massachusetts. 

As it relates to health reform, I think that more than a few people are getting it wrong. Regarding those who say that the election was a rebuke of health reform, or that health reform is dead, I would say, they are full of Boston Beans. 

Here’s why: Massachusetts already has health reform, with an individual mandate, an employer mandate, and, at 97 percent, the highest rate of people with insurance in the country. As of last fall, a full 79 percent of Massachusetts residents supported their reform plan. And health reform legislation, like in the Senate bill, expressly contemplates allowing states like Massachusetts to continue along. 

And to those who would say health reform is dead, I would say, hold on!! Will it be harder? Yes -- there is no denying that both substantively and politically, it will be a tougher road to hoe. But as we have repeatedly said, if health reform was easy, we would have done it decades ago. 

In my mind, the key reason why health reform is not dead -- and cannot be dead -- is that the 31-million-plus reasons why we need health reform did not disappear with yesterday’s election. Simply put, yesterday’s election did not end the problems of people who lack health care, nor did it end unaffordable health care, nor insurance discrimination, nor gender rating, nor insurance coverage that doesn’t meet the needs of women. 

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Weekly Round-Up

Posted by | Posted on: January 19, 2010 at 10:03 pm

by Andrea Maruniak, Program Assistant,
and Delaney Parrish, Intern,
National Women's Law Center
A new report by the PEW Research Center entitled “Women, Men, and the New Economics of Marriage” inspired a widespread media discussion. Jezebel reported on cultural trends highlighted by the report.

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Health Reform Will End Gender Rating, Kind of, Sort of, Maybe…

Posted by Lisa Codispoti, Senior Counsel | Posted on: January 15, 2010 at 08:21 pm

by Lisa Codispoti, Senior Counsel, 
National Women's Law Center 

As we’ve discussed here many times before, gender rating is the harmful and discriminatory insurance practice of charging individuals and employers different premiums based on gender.  

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Why Tax Banks? That’s Where The Money Is.

Posted by Reggie Oldak, Senior Counsel and Director of Government Relations | Posted on: January 14, 2010 at 08:51 pm

by Reggie Oldak, Senior Counsel,
National Women's Law Center

President Obama today called for a “Fiscal Crisis Responsibility Fee” to be paid by about 50 of the largest financial institutions to “recover every single dime the American people are owed” for the bailout of Wall Street.

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Next Step on the Road to Reform: Negotiating Differences Between the House & Senate Bills

Posted by Lisa Codispoti, Senior Counsel | Posted on: January 14, 2010 at 03:35 pm

by Lisa Codispoti, Senior Counsel, 
National Women's Law Center 

We are closer to adopting health reform than ever before in history. Now that the Senate passed their health reform legislation, the next step on the road to reform is for Senate and House leaders to work out differences between their two bills, and then each chamber would vote on the final compromise legislation. And while there are many common provisions between the bills, there are some key differences that the National Women’s Law Center is carefully monitoring and weighing in on to ensure the strongest possible health reform legislation for women and their families. 

For more details on the differences between the two bills, check out our side-by-side comparison of the two bills [PDF], which examines these differences in greater detail. Here are just a few of the issues we are addressing: 

1. Affordability: Regardless of insurance status, women are more likely than men to face affordability barriers to health care. As we’ve repeatedly said, health reform must make health care truly affordable for all women -– especially those with low-and moderate-incomes. While both bills provide affordability assistance to women and families under 400% of poverty (about $43,000 for a single woman, or $88,000 for a family of 4) by expanding eligibility for Medicaid and providing subsidies for both insurance premiums and out-of-pocket costs, the House provides stronger subsidies for those at lower income levels, and their Medicaid expansion is stronger by providing a more robust package of covered services and ensuring that Medicaid enrollees have access to providers by improving reimbursement for primary care providers. Accordingly, we support adopting the House affordability provisions for individuals and families with income under 250% of poverty. 

2. Insurance Reforms: Women have long faced harmful and unfair insurance industry practices, such as gender rating and pre-existing condition exclusions. Both the Senate and House adopted important insurance market reforms that would limit many of these harmful practices; however, the House bill is much stronger because it would eliminate the practice of gender rating and health status rating for individuals and groups of all sizes (while the Senate bill would only apply these rules for individuals and groups up to 100). Furthermore, the Senate bill includes a potentially harmful “wellness” provision that would allow insurance premium discounts of up to 30% for participating in workplace wellness programs -– but would also, conversely, allow premium penalties (i.e. premium increases) for failing to participate in such programs or meet participation benchmarks. We are very concerned about the impact this could have on women, who may be more likely to face a premium penalty given that women are more likely to have a chronic condition that could limit their ability to meet wellness benchmarks. Accordingly, we support the House insurance reform framework, which would provide more robust insurance regulations that would hold insurance companies accountable, and does not include the harmful workplace wellness premium discounts/penalties.

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Health Status Discrimination by Any Other Name is Still Health Status Discrimination

Posted by Kelli Garcia, Senior Counsel | Posted on: January 13, 2010 at 08:38 pm

by Kelli Garcia, Fellow,
National Women's Law Center

I spent six years in graduate school trying to design health prevention and promotion programs that actually work. As a health psychologist I am, generally speaking, a fan of wellness programs, but I am also well aware of their low success rates and potential for unintended consequences. So, I was somewhat skeptical when I learned about new large scale health promotion programs, but the “wellness promotion” provisions in the Senate health reform bill deserve more than skepticism. There is little about them that will promote health and much that will likely harm health, especially for women, minorities and low-income individuals. In fact, the “wellness promotion” provision is really just health status discrimination in disguise. 

Under this provision, employers will be allowed to provide financial incentives to employees who either participate in a healthy lifestyle promotion program or who meet a specified health status standard. Healthy lifestyle programs could include things such as going to a gym regularly or participating in a smoking cessation or weight-loss program.

A health status standard could be a Body Mass Index (BMI) target or a specified cholesterol level. If the reward is predicated on achieving a health status standard, then the reward cannot exceed 30% of total cost, including the employee’s premium and the employer’s contribution, of the employee’s health insurance. This amount could be increased to 50% in the future. Although promoted as a discount, these provisions really penalize those who are unable to participate in wellness programs or who cannot achieve the health status standards.

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Dawn Johnsen’s Nomination is Gaining Momentum!

Posted by Rachel Peck, Fellow | Posted on: January 13, 2010 at 03:10 pm

by Rachel Peck, Fellow, 
National Women's Law Center 

Dawn Johnsen’s nomination to head the Office of Legal Counsel at the Department of Justice is gaining momentum. Last week, the media confirmed that President Obama plans to renominate Dawn Johnsen after Republicans refused to allow her nomination to be held over until the new year.

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Encouraging an Investment in Medicaid Primary Care

Posted by Julia Kaye, Former Health Policy Associate | Posted on: January 13, 2010 at 02:21 pm

by Julia Kaye, Health Policy Associate, 
National Women's Law Center 

The expansion of Medicaid under health reform is a huge victory for women. Under the Senate bill, which raises the income eligibility threshold to 133% of the federal poverty level (FPL), up to 6.8 million uninsured women (ages 18-64) would be eligible for coverage under Medicaid. Under the House bill, which raises the threshold to 150% FPL, that number jumps to 7.8 million uninsured women. However the House and Senate reconcile this discrepancy, one thing’s for certain: millions of women will gain Medicaid coverage if health reform passes.

But will they gain access to the care they need? A large percentage of this newly eligible population, by virtue of having previously been uninsured, may have delayed or forgone important primary and preventive care services in the past, and will be eager to take advantage of their new insurance to receive the care they’ve put off. 

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